Document Detail


Outcome of dual flange metallic urethral stents in the treatment of neuropathic bladder dysfunction after spinal cord injury (SCI).
MedLine Citation:
PMID:  22519741     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Study design: Retrospective case note review. Objectives: To review the results of metallic urethral stents used in patients with neuropathic bladder dysfunction after spinal cord injury (SCI). Setting: Rehabilitation unit for SCI and stroke, Cape Town, South Africa. Methods: We performed a case note review of dual flange Memokath™ stents placed from March 2008 until October 2011. Stents were placed rather than performing an external sphincterotomy in selected patients. With the patient under deep general anaesthesia, a thermo-sensitive expandable metallic stent was positioned over the internal and external urethral sphincters. Results: In total, 33 stents were placed in 28 male patients. SCI was cervical in 23 patients and thoracic in 5. Average follow-up was 18 months (range 1-40 months, median 18 months). The most common indications were repeated catheter blockage in 8 patients and urinary tract infection in 6. The average time from SCI to stent insertion was 79 months (range 1 - 468, median 21 months). Severe autonomic dysreflexia was present in 17 cases prior to stenting and in 7 after stents were placed (p=0.003). Stents failed in 15 patients (45%) and were removed. The most common reason for failure was stone formation. Comparing the group of patients with stents lasting >20 months (n = 11) to the group with stent removal before 20 months (n = 10), the mean time between SCI and stent placement was 31 vs. 119 months (p = 0.057). Medium term results (up to 27 months) were significantly influenced by earlier stent placement (p = 0.0484). One major complication was stent migration that caused an urethro-cutaneous fistula.
Authors:
Andre van der Merwe; Ed Baalbergen; Ray Shrosbree; Shaun Smit; Chris Heyns
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-20
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  -     ISSN:  1557-900X     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Tygerberg Hospital, Urology, Franci van Zijl drive, Tygerberg, Cape Town, South Africa, 7550, 0027 21 938 9282; arvdm@sun.ac.za.
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